Mitral Regurgitation

Mitral regurgitation is a heart condition that occurs when the mitral valve flops back open, leaking some of the blood back into the chamber. When this happens, pressure in the chamber is increased. Depending on how bad the leak is, you may experience a number of different symptoms. The good news is there are medications to control symptoms and surgical intervention to replace the mitral valve in more severe mitral regurgitation.

What Is Mitral Regurgitation?

Your heart is made up of valves that open and close to allow the blood in and out of the chambers of your heart. The mitral valve allows the blood to flow between the top and bottom of your heart.

In mitral valve regurgitation, the blood leaks back to where it came from because the mitral valve does not close all the way. Your heart needs to pump harder to remove any blood that flowed back into the chamber.

Small leaks are very common in a lot of people and most don’t even know they have the problem. Severe mitral valve regurgitation can cause the heart muscle to become weak and eventually cause heart failure.

What Are the Symptoms of Mitral Regurgitation?

Symtoms of mitral regurgitation include:

Heart palpatations (flutters, rapid heart rate)

Persistent cough during the night

Feeling short of breath (during exercise or during the night)

Unexplainable fatigue that increases during exercise

Heart murmur

Swelling in the feet, ankles and lower leg

Some people have no symptoms at all. Others notice a slow progressing. The only way most people find they have the condition is when the doctor hears a heart murmur during a routine physical exam.

When To See A Doctor

If you experience any of the above symptoms you should contact your doctor for an appointment as soon as possible. If you have severe swelling, you need to see a doctor immediately.

What Are the Complications of Mitral Regurgitation?

Heart Failure – This can happen over time and is one of the more severe complications. It causes swelling, increased shortness of breath and fatigue.

Blood Clots – When the left atrium becomes enlarged, you can develop a clot inside. This is very dangerous because clots can travel to other parts of the heart and cause a heart attack, to the brain and cause a stroke or cause blockage in other areas of the body.

Atrial Fibrillation – When the heart fibrillates, it beats very irregular and fast. This results in heart palpatations and shortness of breath. Atrial fibrillation and blood clots can be a very dangerous pair, but often go hand in hand. People with atrial fibrillation are often given prophylactic blood thinners to prevent clots from forming.

Endocarditis – This is a less common complication, but can happen when the heart valve becomes infected. If this complication is not treated quickly, you can become seriously ill.

What Are the Causes of Mitral Regurgitation?

Mitral regurgitation is either chronic or acute. Here is a description of the two types:

Chronic Mitral Valve Regurgitation – This type comes on slowly. The cause is usually a weaker valve that just wears out over time. It can also be caused by rheumatic fever, congenital heart defects, calcium deposits on the valve, and heart failure.

Acute Mitral Valve Regurgitation – This type comes on suddenly and can actually be fatal if untreated. It happens when the valve ruptures and the blood leaks out suddenly. Your heart will be unable to keep up with the quick backflow of blood. Causes of this type are; heart infection, and heart attacks.

What Are the Treatments for Mitral Regurgitation?

Treatments for mitral regurgitation depend on the degree of the condition and the symptoms. Those include:

Medications

ACE Inhibitors (Angiotensin-Converting Enzyme) – These make the work of the heart easier and relieve heart failure symptoms.

Blood Thinners – Warfarin (Coumadin) is given if there is a risk or blood clots and/or you have atrial fibrillation.

Diuretics – If you have heart failure, diuretics help pull extra fluids off the body by stimulating the kidneys to put out more urine. This can help reduce the amount of fluid in the body and reduce the amount of blood flowing back through the heart chambers.

Anti-Arrhythmic Drugs – These medications can help regulate the heart rhythm.

Antibiotics– If you have mitral regurgitation, you will need prophylactic antibiotics before any procedures where you are at risk for infection. You will need antibiotics before dental work and prior to surgery. There are some new healthcare rules that state you may only need antibiotics if you already have an infection. Just ask your doctor what is recommended for you.

Cardioversion Treatments

If atrial fibrillation becomes a problem, doctors can shock the heart back into a normal rhythm.

Surgery

When mitral regurgitation is severe, surgical intervention may be needed. A cardiac surgeon will do an evaluation of your heart valve with imaging tests and help you decide which procedure will be best for you. These procedures include:

Valve Repair – The valve is repaired and strengthened

Valve Replacement – There are valves made from animal tissue or mechanical valves.

Lifestyle Changes

Lifestyle changes can help you have a better quality of life with this condition and protect your heart. These include:

Blood pressure checks. Check your blood pressure on a daily basis and take measures to control your blood pressure.

Lower alcohol intake. If you drink a lot you may experience more irregular heart rhythms. Alcohol can also weaken the heart.

Get exercise. If you don’t already exercise, now is the time to start with your doctor’s okay. Start slow and only push yourself to where you feel comfortable.

Lose extra weight. This can reduce the strain on your heart.

Keep doctor appointments. Stay in touch with your cardiologist and regular physician and get regular check-ups. Make sure if you are female and planning a family that you talk to your doctor about pregnancy. Carrying a baby puts strain on the heart and you may need special care from a cardiologist.